Table 5.
Costs reported for palliative care patients by perspective
| Cost type | Perspectivea | Components | Papers including those costs n (%) |
References |
|---|---|---|---|---|
| Direct healthcare system costs (n = 42) | Primary physician visit | 25 (58.25) | [1–25] | |
| Specialist physician visit | 32 (74.56) | [1–5, 7–9, 11–13, 17, 18, 20–38] | ||
| Specialist nurse visit | 18 (41.94) | [1, 2, 6–9, 13, 20, 22, 25, 26, 28, 29, 31, 32, 37, 39, 40] | ||
| 1. Healthcare system | Physical, occupational therapy visit | 14 (32.62) | [1, 6–9, 11, 21, 22, 25, 29, 31, 33, 37, 39] | |
|
2. Healthcare provider 3. Patient |
Emergency visits | 22 (51.26) | [1, 4–6, 8, 9, 13–15, 22, 24–26, 29, 31, 33, 35, 38, 41–43] | |
| 4. Societal | Day-care hospital | 9 (20.97) | [4, 6, 9, 13, 18, 28, 35, 38, 44] | |
| Domiciliary attention | 28 (65.24) | [2–7, 9, 11, 13, 15, 17–20, 22–27, 29–31, 35, 38, 41, 44] | ||
| Medication | 22 (51.26) | [1–3, 5, 10, 11, 19–25, 27, 30, 32, 33, 35, 39, 43, 44] | ||
| Ambulatory procedures | 2 (4.66) | [33, 35] | ||
| Equipment | 13 (30.29) | [3, 7, 8, 11, 18, 20, 22–25, 30, 33, 39] | ||
| Diagnostic tests and images | 7 (16.31) | [4, 21, 22, 24, 32, 44, 45] | ||
| Acute inpatient attention | 36 (83.88) | [2–5, 7, 8, 10–15, 17–28, 30–33, 35–39, 41, 43, 45] | ||
| Medicalised transportation | 10 (23.30) | [3, 10, 20, 21, 23, 28, 38, 39, 41, 45] | ||
| Direct non-healthcare system costsb (n = 13) | Professional care out of home (hospice, nursing home, day centre) | 2 (4.66) | [9, 38] | |
|
1. Healthcare system 2. Healthcareprovider 3. Patient 4. Societal |
Professional care in home (12/24 hours nurse or professional caregiver) | 6 (13.98) | [9, 15, 24, 30, 37, 38] | |
| Various sanitary services (occupational therapy, psychology, social work, nutrition) | 3 (6.99) | [9, 37, 38] | ||
| Other informal care (spiritual) | 8 (18,64) | [3, 8, 9, 20, 22–24, 32] | ||
| Home adaptations | 1 (2.33) | [9] | ||
| Direct healthcare cost patient (n = 12) | Co-payments | 8 (18.64) | [1, 3, 8, 20, 21, 23, 24, 32] | |
| Private healthcare services (appointments) | 3 (6.99) | [1, 22, 24] | ||
|
1. Healthcare system 4. Societal |
Other healthcare professionals (private practice) | 1 (2.33) | [1] | |
| Medications/equipment not covered or partially covered by public/private service | 6 (13.98) | [8, 20, 22, 24, 30, 32] | ||
| Private transportation | 6 (13.98) | [1, 21, 22, 24, 30, 32] | ||
| Home adaptations paid by patient/caregiver | 2 (4.66) | [1, 8] | ||
| Productivity loss patient (n = 3) | Work absenteeism | 3 (6.99) | [1, 10, 45] | |
| Temporary occupational leave | 1 (2.33) | [10] | ||
|
3. Patient 4. Societal |
Permanent occupational leave | 1 (2.33) | [10] | |
| Early retirement | – | – | ||
| Work decline | – | – | ||
| Total or partial loss of income (self-employed workers) | – | – | ||
| Productivity loss family/caregiver (n = 9) | Work absenteeism | 2 (4.66) | [1, 10] | |
| Temporary occupational leave | 7 (16.31) | [3, 10, 22–24, 30, 32] | ||
| 4. Societal | Permanent occupational leave | 1 (2.33) | [10] | |
| Time devoted to care | 1 (2.33) | [10] | ||
| Loss of leisure time | 6 (13.98) | [8, 10, 22, 24, 30, 32] | ||
| Othersc | Out-of-pocket expenditures | 11 (25.63) | [1, 3, 8, 9, 20, 22–24, 30, 32, 45] |
aThis classification assumes a national health system coverage and includes: 1. Healthcare system, 2. Provider, 3. Patient and 4. Societal perspective
bInclusion of data from a study without specification of perspective [38]
cThere is no agreement in the report between productivity losses by patients or family/caregivers; consequently, the report of out-of-pocket expenditures does not match